WHAT IF…

You could become healthier by changing

ONLY your thoughts?

EXERGAME !

DEFN A video game that is also a form of exercise

Wikipedia

“HEALTHIFYING” EXERGAMES: IMPROVING HEALTH ���OUTCOMES THROUGH INTENTIONAL PRIMING

Frank Chen Abby C. King Eric B. Hekler

TAKEAWAY

It's the little details that are vital. Little things make big things happen.

John Wooden

HOW ARE EXERGAMES TYPICALLY PLAYED?!

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LIKE THIS?!

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Photo  credit:  examiner.com  

LIKE THIS?!

           

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Photo  credit:  nintendo.com  

MORE LIKE THIS?!

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Photo  credit:  nintendo.com  

ACTUALLY PROBABLY LIKE THIS !

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Photo  credit:  42green.com  

DOES EXERGAME USE →!RECOMMENDED 150 MINS MVPA?!

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ACSM. 2008. Physical Activity Guidelines Photo  credit:  flickr.com/bass_nroll  

EXERGAMES !

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Photo  credit:  flickr.com/dcmaster  

EXERGAMES !

Most experiences are “gamifying”

Points, tokens, badges as feedback

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Baranowski, T., et al. 2008. Playing for real…

EXERGAMES !

Wii-fit Usage over three months decreased for eight families

No significant health change

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Owens, S. G., et al. 2011. Changes over three months…

EXERGAMES !

Exergames may be a gateway…

Either towards vigorous exercise or other games

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Schwanda, V., et al. 2011. Side effects and 'gateway' tools

PRIMING !

Priming is the visual, audio, or other sensory cues that provide a subtle shift in attitude, believes or behavior. Prior work has shown explicit intention has an impact on behavior and sustained engagement.

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PRIMING !

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Crum, A. J. & Langer, E. J. 2007. Mind - set matters Photo  credit:  istockphoto.com/asiseeit  

PRIMING !

N = 84 hotel maids. 4 weeks. 66.6% no regular PA

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Crum, A. J. & Langer, E. J. 2007. Mind - set matters Photo  credit:  istockphoto.com/asiseeit  

PRIMING !

N = 84 hotel maids. 4 weeks 66.6% no regular PA Improved BMI, body fat %, blood pressure No reported behavior change

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Crum, A. J. & Langer, E. J. 2007. Mind - set matters Photo  credit:  istockphoto.com/asiseeit  

HYPOTHESES !

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Photo  credit:  flickr.com/shuGerhack  

HYPOTHESES !

Exercise:

More intense; shorter ; decreased positive affect

Gaming: Less intense; longer; increased positive affect

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Dishman, R.K., et. al. 1985. The determinants of physical activity and exercise.

METHODS !

N = 44. Stanford students, staff, post-docs 70% reported regular exercise Measurements: RPE, EE, Duration, PA

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METHODS !

Used Dance Central

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FACTORS: PRIMING X FEEDBACK !

Priming “You’re exercising” “You’re playing”

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FACTORS: PRIMING X FEEDBACK !

Priming “You’re exercising” “You’re playing”

“Workout” mode

“Perform It” mode

Feedback  

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FACTORS: FEEDBACK !

“Perform It” mode

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Photo  credit:  ign.com  

FACTORS: FEEDBACK !

“Workout” mode

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Photo  credit:  ign.com  

FACTORS: PRIMING !

(Default) “You’re playing”

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FACTORS: PRIMING !

“You’re exercising”

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DESIGN !

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Recruit “Kinect as Stress Reliever”

DESIGN !

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Recruit Pre-randomized

DESIGN !

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Recruit Pre-randomized Instrumented

DESIGN !

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Recruit Pre-randomized

Pre-Survey

Instrumented

DESIGN !

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Recruit Pre-randomized

Priming “Please play” “Please exercise”

Pre-Survey

Instrumented

DESIGN !

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Recruit Pre-randomized

Feedback “Perform” “Workout”

Priming “Please play” “Please exercise”

Pre-Survey

Instrumented

“Break it down”

DESIGN !

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Recruit Pre-randomized

Feedback “Perform” “Workout”

Priming “Please play” “Please exercise”

Pre-survey

Instrumented

“Break it down” Post-survey / interview

DESIGN !

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Recruit Pre-randomized

Feedback “Perform” “Workout”

Priming “Please play” “Please exercise”

Pre-survey

Instrumented

RESULTS !

People “exercised” about 25% longer in a single session

0  

20  

40  

60  

Game  prime    Exercise  prime  

Dura%o

n  of  Use  (m

inutes)   Gaming  feedback  

 Exercise  feedback  

M = 39.3 ± 3.0 min < M = 49.2 ± 2.0 min 2014/4/29   @frankc   37  

FACTORS: PRIMING X FEEDBACK !

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Priming “You’re exercising” “You’re playing”

“Workout” mode

“Perform It” mode

Feedback  

FACTORS: PRIMING X FEEDBACK !

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+25%  duraLon  

Priming “You’re exercising” “You’re playing”

“Workout” mode

“Perform It” mode

Feedback  

“TELL US ABOUT YOUR SESSION” !

“I played through many songs […] I really liked and had a lot of fun. I found myself becoming very competitive, more than I had imagined I would [because I do not play a lot of games]." <M, G×nH>

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“TELL US ABOUT YOUR SESSION” !

“This could be one of the things I do to train. What you see a lot on dance teams is it’s difficult to learn new routines due to lack of feedback on what I’m actually doing…” <F, E×nH>

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DUAL BENEFITS !

“I think this is a great game. I typically run and do strength training and burn about 360 calories at the gym per session. You could have used a different game… It’s still not as efficient as a workout at the gym.” <M, E×nH>

•  Eight in exercise priming; three in gaming priming

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“GAMIFICATION” !HEALTH FEEDBACK IN EXERGAMES !

No participants mentioned health feedback as particularly insightful or motivating “I did not use the feedback […] I play sports. I don’t run or lift weights. Exercise is boring, rather than doing something monotonous I like to play games.” <F, E×H>

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ADDED BENEFIT !WITH PRIOR EXPERIENCE!

Excellent as learning cues “This could be one of the things I do to train. What you see a lot on dance teams it’s difficult to learn new routines due to the lack of feedback on what I’m actually doing.” <F, E×nH>

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RESULTS !

Exertion = 4.5 MET ~ MVPA We saw no significant effect on RPE, EE, or PA

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LIMITATIONS !

Single session

70.4% of our participants reported regular activity ���48.4% for the rest of the US

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CDC. 2011. Health, United States.

HEALTHIFICATION!

Gamification is not enough without embedding this activity deeply in the activity. Cannot be “bolted on” Healthifying = Emphasizing dual benefits of the activity so it's more engaging to the individual

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“HEALTHIFYING” EXERGAMES !

@frankc

Intentional priming emphasized the dual purpose of Dance Central Framed a strong game as exercise and increased duration of use by 25% Gamification might be too blunt of an instrument. Psychology offers a rich set of tools and principles that lead to long-term healthful impact.

@ehekler